Meal-planning basics for type 2 diabetes

Does your idea of an eating plan mean simply that you plan to eat at some point when you get hungry? Are the "what" and "how much" left to be discovered when you open the refrigerator door or sit down at the table? While this approach cannot be endorsed as a design for healthy food consumption for anyone—much less people with diabetes or those who are at risk for this disorder—it's an accurate description of how many Americans approach meals.

But the more we learn about the influence of diet on long-term health and well-being, the more important it becomes to make wise, conscientious food choices. When you have diabetes, this is even more crucial.

Meal planning usually begins with a visit to a dietitian. Your first meeting with the dietitian will be largely devoted to compiling a nutritional assessment—your "diet history." This analysis of your eating and lifestyle habits will take about an hour. It may be helpful if you bring to your first visit a diary listing everything you have eaten over a three-day period (ideally, two weekdays and one weekend day), with approximate serving sizes. During this session, you and the dietitian will discuss which types of food you eat, when you eat, and who does the shopping and food preparation in your household.

Choose a meal plan

When it comes to meal planning, no one strategy suits every person's tastes or lifestyle. But two systems tend to be used most commonly: the exchange system and carbohydrate counting. You and your dietitian will decide which planning system works best for you.

The exchange system

The modern era of meal planning was ushered in with the advent of theExchange Lists for Meal Planning in 1950. These now-familiar food lists were designed in a joint effort by the American Diabetes Association, the American Dietetic Association, and the U.S. Public Health Service to make meal planning more consistent among nutrition professionals and more accessible to patients. The exchange lists have been revised numerous times over the years to keep pace with popular tastes.

Many people with diabetes still find the exchange system a useful tool, especially those who benefit from detailed information about serving sizes and food content. Based on your daily calorie goal and blood sugar goals, your dietitian will designate the number of servings from each of several food groups that you should include in your meals to meet your daily caloric needs.

Carbohydrate counting

This meal-planning system tends to be less complicated and more accurate than other approaches because it focuses on only one major nutrient. It also allows more flexibility to include combination foods such as soups and casseroles in your diet because you don't have to worry about finding a particular food item in the exchange lists.

The first step in tracking your carbohydrates is to assess the number of calories you need to take in each day, with the help of your dietician. From this number, you and your dietitian will determine what portion of this energy total should come from carbohydrate foods.

Sample recipe

As you begin to pay more attention to your diet and meal planning, you'll discover that something can taste good and still be good for you. Here is one example to get you on the road to healthier eating:

Turkey Bolognese with Roasted Red Pepper
Makes 4 to 6 servings (1 cup cooked pasta and ? cup sauce per serving)

1 pound whole-wheat pasta
1 tablespoon olive oil
2 teaspoons minced garlic
? cup diced red onion
2 teaspoons ground fennel seed
2 teaspoons dried sage or ? tablespoon fresh chopped sage
1 teaspoon ground black pepper
1 pound ground turkey breast
1 (25-ounce) jar tomato sauce with vegetables (such as mushrooms, peppers, etc.); choose sauce without any added sweeteners
1 cup diced roasted red peppers

Cook pasta according to package directions. Meanwhile, place olive oil in large saucepan. Heat gently on low heat. Add garlic, red onion, ground fennel seed, sage, and black pepper. Cook, stirring occasionally, until onion is translucent. Increase heat slightly and add ground turkey. Stir constantly until meat is broken up into small pieces and no pink color remains in the meat. Add tomato sauce and roasted red peppers and heat another 5 minutes until hot. Remove from heat and serve over the whole-wheat pasta.

Nutrition information per serving

Calories: 514
Total fat: 13.1 grams
Saturated fat: 2.6 grams
Trans fat: 0 grams
Cholesterol: 64.3 milligrams
Sodium: 664 milligrams
Total carbohydrates: 69.3 grams
Fiber: 9.4 grams
Sugars: 8.5 grams
Protein: 26.2 grams
Carbohydrate choices per serving: 4.6